Marquita D Mack, L.P.N

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

276635-1 Issued in NY

Practice address

535 Stockbridge Ave
Buffalo, NY 14215-1707

Phone

(716) 894-5462

NPI assigned

Mar 16, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Marquita Smith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1225279524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 STOCKBRIDGE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151707",
            "telephone_number": "716-510-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 STOCKBRIDGE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142151707",
            "telephone_number": "716-894-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MARQUITA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "L.P.N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "276635-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARQUITA",
            "last_name": "SMITH",
            "prefix": "MRS.",
            "credential": "L.P.N",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diana Macie
• Mary Maciejewski
• Deborah Ann Maciolek, P.A.
• Allison Maciver, M.D.
• Catherine Sue Mack, FNP
• Monica Mack
• Tyler D Mack, MD
• Patrick Mackenna, CASAC-T
• Brianne Mackenzie, MD, MSC
• Emily Mackenzie

• Licensed Practical Nurse in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.